PMID: 16534319Mar 15, 2006Paper

Anaesthesia management for pulmonary endarterectomy

Current Opinion in Anaesthesiology
Roland DemeyereWillem Daenen

Abstract

Options for the surgical treatment of chronic thromboembolic pulmonary hypertension are either lung transplantation or pulmonary endarterectomy. Pulmonary endarterectomy is considered permanently curative and the treatment of choice. The procedure dramatically improves functional status and provides an excellent immediate and long-term survival, much better than transplantation. Pulmonary endarterectomy, until recently performed in only a few highly specialized centres, is now spreading worldwide with good results. This review will focus on the understanding of the pathophysiology of the disease and on recent advances in assessment and treatment strategies. Recent data reinforce the thromboembolic nature of chronic thromboembolic pulmonary hypertension, and have shown that the disorder is more common than was thought and remains underdiagnosed. There has recently been a remarkable surge in the understanding of the mechanisms involved in the pathogenesis of pulmonary hypertension. Advances in diagnosis, surgical techniques, preoperative treatment, and perioperative management have improved the prognosis of this debilitating disease. New information about pretreatment and medical treatment with prostanoids and endothelin receptor...Continue Reading

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